Analysis of Suicidal Behavior in Adult Inpatients with Anorexia Nervosa: Prevalence of Suicide Attempts and Non-Suicidal Self-Injury and Associated Factors—Data Before and After the COVID-19 Pandemic

<b>Background/Objectives</b>: Anorexia nervosa (AN) has a high mortality rate frequently related to suicidality; however, there are few studies on suicide attempts (SAs) and non-suicidal self-injuries (NSSIs) in adult inpatients with AN. This study aims to describe SA and NSSI prevalence and related clinical and sociodemographic factors in adult inpatients with AN. <b>Methods</b>: We retrospectively analyzed data on 298 inpatients hospitalized between 2014 and 2023. Suicidality and clinical and sociodemographic data were collected by experienced psychiatrists; then, the patients completed a battery of self-report questionnaires investigating eating-related and general psychopathology. <b>Results</b>: A total of 9.7% of the inpatients reported an SA in their lifetime, and 13.4% reported NSSI. The percentages were lower among patients with restricter-type AN (5.6% SA and 6.6% NSSI) and higher among patients with binge-purging AN (18% SA and 27% NSSI). SAs were associated with unemployment, binge-purging AN, personality disorders, and lifetime sexual abuse; NSSIs were correlated with family psychiatric disorders, binge-purging AN, personality disorders, body dissatisfaction, restriction, and eating-related concerns. No differences emerged in the frequency of reported suicidality between patients tested before and after the COVID-19 pandemic. <b>Conclusions</b>: Suicidality is a relevant issue in AN. Many factors in the history of the patients and their eating-related pathologies should be considered as potentially associated with SA and NSSI and carefully assessed.